Today, the costs of educating and training surgeons amount to approximately $50,000 per physician annually. With more than 5,000 trainees enrolled in surgical training programs nationwide, national expenditures amount to $250 million dollars per year. However, the human body is an extremely complex system and even though training investments are high, exposure to operative practice is often limited to random scenarios, dependent on patient caseloads that are available in local teaching hospitals over the course of the training period. The traditional learn-by-doing approach is simply ineffective in today?s fast-paced surgical environment where the application of computing to surgery is anticipated and where patients have little tolerance for doctors who learn surgical skills for the first time while working on them. Our overall aim in the proposed effort is to develop a prototype simulation-based training environment system and quantify its performance along objective, subjective, training transfer dimensions. To create such a system we will combine 1) creation of a 3D visio-haptic workstation with high quality stereo images and bi-manual haptic interfaces, with 2) advanced volumetric simulation methods for biomaterials, 3) new methods for detecting collision between and within deformable bodies 4) detection of physiologically relevant physical events during interaction with the simulations, and 5) modeling ensuing physiological consequences. The resulting standardized system will combine physical and physiological real-time simulation to create an environment wherein alternative simulation techniques can be evaluated, and to which clinically motivated curricular content can be added. Potential applications include training for combat casualty care, trauma response and telerobotic medicine, telemedicine and haptic skill mentoring and rehab. The long term goal of the proposed project is to develop dynamic models and simulation-based training technologies that can be used to improve the breadth and quality of surgical education, minimize risks to patients and teaching hospitals, and reduce overall healthcare costs. Echoing the success of simulation-based training methods in commercial airline and space travel industries where the cost of error is very high, we expect the proposed will develop new and more effective computer-based and robust surgical simulation platform that will reduce eliminate expensive animal and cadaver models, reduce training time, provide a cost-effective method of re-certifying doctors annually, and lower overall healthcare costs.